Nursing Home Staffing Shortages and Other Problems Persist, U.S. Report Says

Many Americans prefer to believe the Covid pandemic is a thing of the past. But for the nation’s nursing homes, the effects have yet to fully fade, with staffing shortages and employee burnout still at crisis levels and many facilities struggling to stay afloat, according to a new report published Thursday by federal investigators.

The report, by the inspector general’s office at the U.S. Department of Health and Human Services, found that the flawed infection-control procedures that contributed to the 170,000 deaths at nursing homes during the pandemic were still inadequate at many facilities. And while the uptake of Covid vaccines was initially robust when they first became available, investigators found that vaccination booster rates among staff workers and residents have been badly lagging.

The findings were directed at the Centers for Medicare & Medicaid Services, the agency under the department’s jurisdiction that oversees 1.2 million nursing home residents whose care is provided mainly by the federal government. The inspector general’s report described the staffing problems as “monumental,” noting high levels of burnout, frequent employee turnover and the burdens of constantly training new employees, some of whom fail to show up for their first day of work. For nursing homes, the inability to attract and retain certified nurse aides, dietary services staff and housekeeping workers is tied to federal and state reimbursements that do not cover the full cost of care.

Rachel Bryan, a social science analyst with the inspector general’s office, said the report sought to ensure that key lessons from the pandemic were not lost, especially now that the acute sense of urgency has faded.

“Just as airplanes cannot be repaired while in flight, nursing home challenges could not be fully repaired during the pandemic,” she said. “We feel very strongly that as we come out of emergency mode, we take the time to reflect, learn and take real steps toward meaningful change.”

The Centers for Medicare & Medicaid Services declined to discuss the recommendations, and instead directed a reporter to comments the agency provided for the report. Those comments were largely noncommittal, neither agreeing or disagreeing with the recommendations, but agency officials asked that some of the proposed recommendations be removed from the report, saying improvements were already in the works.